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General NPI Number Information
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NPI Number | 1386033918
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Entity Type | Organization
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Legal Business Name | PIVOTAL CONNECTIONS LLC
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 22378 THREE NOTCH RD UNIT B
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-2003
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Country | US
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Telephone | 757-232-9877
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Fax |
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Provider Business Mailing Address
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Address Line | 3051 LITTLE POND ST
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City | MCKINLEYVILLE
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State | CA
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Zip | 95519-9476
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Country | US
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Telephone | 757-232-9877
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DR. SANDRA B BUCHHEISTER
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Credential | DPT
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Telephone | 757-232-9877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 24712
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 43586
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License Number State | CA
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